Injuries of the finger flexor ligaments: diagnosis and treatment

Authors

  • Alexander Anatoliiovych Buryanov O.O. Bogomolets National Medical University
  • Volodymyr Petrovych Kvasha O.O. Bogomolets National Medical University
  • Anatolii Ivanovych Kanziuba state higher educational institution «Uzhgorod National University»
  • Dmytro Yuriiovych Kovalchuk O.O. Bogomolets National Medical University
  • Yurii Leontiiovych Sobolevskyi O.O. Bogomolets National Medical University

DOI:

https://doi.org/10.32782/2415-8127.2022.66.1

Keywords:

injury of the hand finger flexor ligaments, ligament suture, rehabilitation.

Abstract

Introduction. The hand injury is one of the most common skeletal traumas, with occurrence of up to 50% in various age groups, including children. Among different hand injuries, those accompanied by the finger ligaments injuries make up 1.5-2%, which is up to 21% of all hospitalizations for this injury. Most patients are men, aged 18-45 years old. To choose the best treatment tactics, it is important to estimate the injury character and ligament injury severity. The main intra-operation tasks are providing atraumatic course and the choice of the ligament suture, and the postoperative ones – introducing individual appropriate rehabilitation measures. Objective: to expand knowledge of the medical students, masters, interns, clinical residents and PhDs specialized in “Orthopedics and Traumatology” about treatment of injuries of the finger flexor ligaments. Materials and methods of the study. The literature sources of the Pubmed, Up-to-date, Cochrane library, Science direct and Scopus database have been reviewed using search words “hand, ligament sutures”. Results and Discussion. The decision on the terms of recovery of the flexor ligaments is based not only on the established injury, but assessment of the wound and its characteristics. An important component which provides positive final outcome during operative intervention is assessment of the injured ligament condition and suture choice, which affects the choice and volume of rehabilitation program in a certain patient. Having analyzed modern views and discussions about the ligament suture, one can conclude that no “golden standard” has been accepted yet, which will completely satisfy both a patient and a physician. Conclusion. 1.Injury of the ligaments of the hand finger flexors make up to 1.5-2% of hand traumas, which is represented by up to 21% of such hospitalizations. Regarding the young age of the patients and a significant percentage of unsatisfactory outcomes, the issue calls for subsequent study and improving the treatment approaches. 2. Anatomical and biological knowledge provides for significant decrease in diagnostic errors and the operative intervention traumatic share. The main factor for the operative intervention choice is the ligament suture choice. 3. To provide for the positive final result, an individual rehabilitation program, which depends on the injury type, ligament suture and individual patient characteristics, should be introduced. This is why, to implement it, an orthopedist and rehabilitation physician should cooperate.

References

Ju-Yul Yoon, Da-Sol Kim, Gi-Wook Kim, Myoung-Hwan Ko, Jeong-Hwan Seo, Yu Hui Won, Sung-Hee Park. Motor Organization in Schizencephaly: Outcomes of Transcranial Magnetic Stimulation and Diffusion Tensor Imaging of Motor Tract Projections Correlate with the Different Domains of Hand Function. Biomed Res Int. Published online 2021; Sep 6. doi: 10.1155/2021/9956609.

Mohammad M.Haddara. The Effect of Wrist Position on Finger Tendon Loads Followins Pulley Sectionins and Operative Reconstruction. Jornal of Hand Surgery Global on line.2019; 1:154-1603.

Haoyu Liu, Andrew Thoreson, Assaf Kadar, Steven Moran, Chunfeng Zhao. Evaluation of hollow mesh augmentation on the biomechanical properties of the flexor tendon repaired with modified Kessler technique. Acta Orthop Traumatol Turc. 2019; Nov; 53(6): 474–477. doi: 10.1016/j.aott.2019.07.003

Hari Venkatramani, Vigneswaran Varadharajan, Praveen Bhardwaj. Flexor tendon injuries. J Clin Orthop Trauma. 2019. 853–861 doi: 10.1016/j.jcot.2019.08.005/

Seyyid Serif Unsal, Tugrul Yildirim, Mehmet Armangil. Comparison of surgical trends in zone 2 flexor tendon repair between Turkish and international surgeons. J Orthop Translat. 2020 Jan; 20: 80–85. doi: 10.1016/j.jot.2019.08.005

Sinel’nikov R.D. Atlas anatomiicheloveka T I: Uchenie o kostjah, sustavah, svjazkah i myshcah.Izdatel’stvo «Medicina» Moskva, 1967. C. 344-372

Strfun S.S., Bezuglyj A.A. Dvuhjetapnaja plastika suhozhilij sgibatelej pal’cev kisti. Kiev:OLBI. 2013.200s.

Wenfeng Yang, Jvtao Li, Yuewen Su. A Modified Flexor Tendon Suture Technique Clinics (SaoPaulo) 2021; 76: e2358. Published on line 2021 Apr 26. doi: 10.6061/clinics/2021/e2358.

Kevin J. Zuo, Moaath Saggaf, Herbert P. von Schroeder, Paul Binhammer. Outcomes of Secondary Combined Proximal Interphalangeal Joint Release and Zone II Flexor Tenolysis. Hand (N Y). 2020; 15(4): 502–508. doi: 10.1177/1558944719828005

Kleinert H.E., Schepels S., Gill T. Flexor tendon injuries. Surg Clin North Am. 1981. 61. Р.267–286.

Duran R.J., Houser R.G., Coleman C.R.[at al.]. Management of flexor tendon lacerations in zone 2 usingcontrolled passive motion postoperatively. In: Hunter J.M., Schneider L.H., Mackin E.J., eds. Tendon surgery inthe hand. St Louis: CV Mosby. 1978. Р. 178–182.

Published

2022-12-11

How to Cite

Бур’янов, О. А., Кваша, В. П., Канзюба, А. І., Ковальчук, Д. Ю., & Соболевський, Ю. Л. (2022). Injuries of the finger flexor ligaments: diagnosis and treatment. Scientific Bulletin of the Uzhhorod University. Series «Medicine», (2(66), 5-11. https://doi.org/10.32782/2415-8127.2022.66.1